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This study evaluated the impact of structured training in evidence-based risk assessment for suicide.Forty-five psychiatry and psychology trainees participated in a workshop on evidence-based risk assessment. A comparison group of ten psychiatry trainees participated in a different workshop on the application of evidence-based medicine to psychiatry that was not focused specifically on risk assessment. Before and after each workshop, participants rated their skills in assessing patients' risk of suicide and wrote progress notes regarding clinical vignettes that included the assessment of and plan regarding suicide risk. Researchers systematically rated the progress notes.Participation in risk assessment training predicted improvement on specific indicators of documentation quality, ratings of the overall quality of documentation of suicide risk, and self-rated competence in suicide risk assessment.Structured clinical training in evidence-based risk assessment can improve documentation of assessment and management of patients' risk of suicide.

The authors assessed base rates of firearm possession reported by hospitalized psychiatric patients.The study involved retrospective review of the charts of 100 patients consecutively admitted after a hospital had incorporated routine firearm screening in the workup done at admission and the charts of 100 patients who had been consecutively admitted during an earlier interval when firearm screening had been done on an as-needed basis.Whereas one patient (1%) acknowledged having access to a firearm when screening had been done on an as-needed basis, under conditions of routine screening, nine patients (9%) reported owning or having access to a firearm.A substantial proportion of hospitalized patients have access to firearms. Unless patients are directly asked about firearm access, this information may not come to the attention of health care providers. Strategies to manage the risk of suicide and violence by hospitalized patients may benefit from routine assessment of firearms possession.

Older adults are among the highest at risk group for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental healthcare. However, providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of health care providers who may see older adults in their care settings. One hundred and thirty two participants from two VA Medical Centers participated in a 6.5 hour long workshop in the assessment and management of suicide risk among older adults. Participants were asked to complete pre- and- post workshop case notes and report on subjective changes in knowledge, attitude, and confidence in assessment and managing suicide risk in older adults. Participants included social workers, nurses, physicians, psychologists, and occupational therapists coming from a variety of care settings including outpatient and inpatient medical, outpatient and inpatient mental health, specialty clinics, and home and community. Following the workshop, participants demonstrated improvement in the overall quality of case notes (p